What's really the best way to build muscle, boost strength, and maintain athletic performance for the long haul? We all know resistance training and protein are key, but how do we combine them for maximum effect? And does adding other types of training help or hurt?
A massive new network meta-analysis published in The Journal of Nutrition, Health & Aging just gave us the clearest answers yet. Researchers pooled the data from 96 randomized controlled trials involving 7,596 people to compare a huge range of interventions head-to-head. They looked at everything from resistance training alone to aerobic training, whole-body vibration, protein supplements, and every combination in between.
While the study focused on adults with sarcopenia (age-related muscle loss), the findings provide a powerful blueprint for anyone serious about building and preserving a strong, functional body. Let's break down what they found.
Resistance Training is Still King, But It Has a Powerful Ally
No surprises here: resistance training (RT) remains the undisputed champion for building muscle and strength. But the study revealed a crucial nuance. When it came to improving functional outcomes—things that matter in sport and life, like walking speed, balance, and the ability to get up and go—multicomponent programs consistently beat resistance training alone.
The most effective combination for overall performance was Resistance and Balance Training combined with Protein-based Nutrition (RBT + Nu).
This combo produced the biggest improvements in:
- Handgrip Strength: A key indicator of overall strength.
- Gait Speed: This group saw clinically meaningful improvements, meaning the change was large enough to significantly impact daily function and reduce mortality risk.
- Short Physical Performance Battery (SPPB): A combined test of balance, walking speed, and sit-to-stand ability. Again, the improvements were clinically meaningful.
Why does adding balance training make such a difference? The researchers suggest that while RT builds the raw horsepower, balance training teaches the nervous system how to use that strength effectively. It improves proprioception, postural control, and coordination, allowing strength gains to transfer better to complex, dynamic tasks. For an athlete, this means better agility and control. For a lifter, it means a more stable base for heavy lifts and a reduced risk of injury.
For Pure Muscle Mass, Keep It Simple
Here’s where it gets interesting for the hypertrophy crowd. While adding balance and aerobic work was superior for function, the best intervention for packing on pure muscle mass was simpler.
The winning combination for increasing Appendicular Skeletal Muscle Mass Index (ASMI) was Resistance Training combined with Protein-based Nutrition (RT + Nu).
RT alone also produced moderate benefits, but adding protein took it to the next level. This suggests that if your single-minded goal is hypertrophy, a focused, heavy resistance training program paired with adequate protein is the most direct path.
The study points to a potential "interference effect." Combining aerobic or extensive balance work with lifting can activate competing cellular pathways (AMPK vs. mTOR). This might slightly blunt the anabolic signals from resistance training, leading to slightly smaller gains in muscle size compared to a pure RT program. It's a classic trade-off: specialize for maximum size, or generalize for maximum real-world performance.
Protein: The Essential Teammate
The data was crystal clear on one thing: exercise plus protein is better than exercise alone. In nearly every comparison, adding nutritional support amplified the benefits of the training program.
- RT + Nu beat RT alone for improving gait speed and muscle mass.
- RBT + Nu beat RBT alone for improving grip strength, gait speed, SPPB scores, and total skeletal muscle.
Protein supplementation on its own had only modest effects. Its real power is unlocked when it's used to support the stimulus from hard training. It provides the building blocks needed to repair and build muscle, creating a more favorable anabolic environment.
Digging deeper, a subgroup analysis found that combining exercise with both protein and amino acid supplementation seemed to yield even greater benefits than exercise with protein alone. This was especially true for grip strength, gait speed, SPPB, and muscle mass, highlighting the synergistic role of specific amino acids (like leucine) in driving muscle protein synthesis.
What About EMS and Whole-Body Vibration?
The study also looked at simulated exercise like electrical muscle stimulation (EMS) and whole-body vibration (WBV). The verdict? They aren't a substitute for actual training.
While these methods showed very high adherence rates—likely because they are less demanding—their effects on muscle, strength, and function were generally small and of uncertain clinical importance. They might serve as a temporary tool for individuals who are injured or unable to participate in conventional exercise, but they won't build the strength and resilience that comes from moving a heavy load through space.
Key Takeaways for Your Program
This comprehensive review provides a clear, evidence-based hierarchy for effective training and nutrition. Here’s how to apply it:
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Build Your Foundation on Resistance Training: This is the primary driver of strength and hypertrophy. Don't compromise on it.
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Pair Every Workout with Protein: To maximize your gains from training, ensure your protein intake is sufficient. The evidence shows it's not an optional add-on; it's an essential component for optimizing results.
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For Better Performance, Add Balance & Stability Work: Don't just live in the sagittal plane with barbells. Incorporate unilateral exercises (split squats, single-leg RDLs), loaded carries, and other movements that challenge your stability. This will make your strength more usable and make you a more resilient athlete.
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Understand the Trade-Offs: If your only goal is maximum muscle mass, a highly focused RT program might be best. If you want that muscle to perform athletically and carry you through life, a multicomponent approach that blends strength and stability is superior.
Ultimately, this study confirms what many great coaches have known for years: strength is the foundation, but it must be supported by smart nutrition and complemented with training that builds a well-rounded, functional body.
Reference:
Yan, R., Jia, S., Lu, D., Song, W., Zhang, W., Sun, J., & Li, D. (2025). Comparative Effectiveness of Exercise and Protein-Based Interventions on Muscle Strength, Mass, and Function in Sarcopenia: A Systematic Review and Network Meta-Analysis. The Journal of Nutrition, Health & Aging. https://pubmed.ncbi.nlm.nih.gov/41205420/